A-Fib Doesn't Mean You're Banished to the Sidelines

FRIDAY, Jan. 10 (HealthDay News) -- Cutting back on exercise, or
stopping altogether, might seem like the right move for people
whose heart beats too fast and erratically, a condition called
atrial fibrillation. But that's not necessarily so.

In fact, staying active -- biking, swimming, perhaps even
playing pickup basketball, for instance -- might be just what the
doctor ordered.

The key, heart experts say, is to make sure the heart rate
doesn't go above a certain level, or that exercise doesn't trigger
an uncontrolled heart rhythm.

"There's a very common misunderstanding that a lack of exercise can help prevent heart rhythm problems, and that's not true for the far majority of people," said Dr. Emile Daoud, a cardiologist and chief of the cardiac electrophysiology section at Ohio State University's Wexner Medical Center in Columbus, Ohio.

"If you have atrial fibrillation, don't presume that you shouldn't exercise," Daoud said. "Ask your doctor what's safe for you. Some people with atrial fibrillation have other cardiovascular issues that might limit exercise, but for most people, moderate amounts of exercise probably help."

The heart has its own electrical system that controls the rate
and rhythm of the heartbeat. "If you have atrial fibrillation, it
means that the pacemaker God gave you isn't exactly working the way
it's supposed to," said Dr. Jerry Insel, chief of cardiology at
MedStar Good Samaritan Hospital in Baltimore.

Normally, the electrical signal travels from the atria at the
top of the heart to the ventricles at the bottom of the heart. If
this electrical system malfunctions, the heart doesn't beat
properly, and can't pump blood to the rest of the body efficiently,
according to the U.S. National Heart, Lung, and Blood
Institute.

In atrial fibrillation, the atria and the ventricles pump at
different rates, which can allow blood to pool, increasing the risk
for blood clots. That puts people with atrial fibrillation at an
increased risk for stroke, often necessitating blood-thinning
medications to keep clots from forming when the heart is beating
irregularly.

People with atrial fibrillation may also take medication to
control their heart rate. And, if that isn't enough to restore a
normal heart rhythm, doctors may opt to shock the heart back into a
normal rhythm with electrical cardioversion.

Some people have short, infrequent episodes of atrial
fibrillation, while others have persistent a-fib. Even those with
persistent atrial fibrillation, however, may be able to exercise
without a problem, Insel said.

Both doctors said that the decision on whether someone with
atrial fibrillation can exercise, though, has to be made on an
individual basis, based on the type of atrial fibrillation they
have and their body's response to exercise.

"Exercise can be an issue for some people," Insel said. "With aerobic activity, the heart rate can go up a lot faster. With resistance exercise, it may go slower," he explained.

"It's hard to predict what someone's initial response to exercise will be, so I tell my patients to take it slow," Insel said. "Start with walking -- walking in the house or in the mall -- to see what happens with the heart rate. If it goes up above 150 to 160, we may need to prescribe medication."

But overall, Daoud said, "once we know that the heart muscle is
good, and it's just an electrical problem, we try to encourage
people to return to as normal a lifestyle as possible."

And, Daoud added, "Like everything else in life, moderation is
important. For the average person who likes to exercise 45 minutes
to an hour in the gym or playing tennis, that type of exercise
probably won't promote a-fib. If you like tennis, go out and play
tennis, enjoy. If you have an episode of a-fib while playing, stop
and rest for a bit. If you have another episode while you're
playing, stop and don't exercise for the rest of the day."

But that doesn't mean that exercise is out altogether. "It's
important to note that telling people not to exercise won't stop
a-fib from happening," Daoud said.

In fact, Daoud said there are very few activities he considers
off-limits for people with atrial fibrillation. His only rule:
"Nothing that makes you grunt," he said, which means heavy
weight-lifting is out. But walking, golf, tennis, swimming, biking,
even team sports like soccer or basketball may be OK, he said.

The bottom line, according to Insel, is that "the risk factors
that contribute to atrial fibrillation are only helped by activity,
so work out a plan with your physician on how to stay active
safely."

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.